Agreement for Placement Agency in India by lqa17524


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									                          FAMILIES THRU INTERNATIONAL ADOPTION
                                         (a state licensed not-for-profit child placement agency)

                                     e-mail: web site:
                                    Toll-free 888-797-9900 • Phone 812-479-9900 • Fax 812-479-9901
                                               400 Bentee Wes Court, Evansville, IN 47715

We/I, ADOPTIVE PARENT(S) NAME(S), the undersigned, hereby acknowledge receipt of our/my
picture(s) and child study on ADOPTIVE CHILD NAME. We/I understand that we/I have been provided all
the medical information that was provided to Families Thru International Adoption (FTIA) by the Indian
adoption officials or orphanage. FTIA has very clearly stated that they do not guarantee the accuracy of
any medical information provided by the Indian authorities or the orphanage. We/I understand, and with
full knowledge that we are/I am not certain of the medical/social/ developmental/emotional condition of
ADOPTIVE CHILD NAME, by our/my signature(s) below, we are/I am agreeing to complete the
adoption/guardianship of ADOPTIVE CHILD NAME through FTIA by traveling to India when permitted by
the Indian adoption officials. We/I further agree that upon the decision to accept the referral of
ADOPTIVE CHILD NAME to overnight the first half of international fee ($4,500) and the balance of the
agency fee ($2,300) along with this signed Acknowledgment and Agreement and the signed and
notarized child study to Families Thru International Adoption.

We/I understand that India requires post-placement/post-adoption reports every three months for two
years after we/I return from India then every 6 months for the next three years. The first 3 post-placement
reports are to be completed by the social worker who completed the original home study or another
licensed home study agency. We/I understand that the remaining post-placement/post-adoption reports
may be completed as family reports unless notified differently by FTIA. We also agree to send 6-8
photographs with each post-placement/post-adoption report. By our/my signature(s) below, we are/I am
agreeing to complete the post-placement/post-adoption reports as required by India, although this may
present additional cost. We/I also agree that if India changes their post-placement/post-adoption
requirements to require additional post-placement/post-adoption reports, to comply with the Indian
regulations even though it will result in additional costs.

We/I agree to adopt ADOPTIVE CHILD NAME in our state of residence within 1 year after we/I return
from India and, we/I agree to provide three copies of the certified Adoption Decree to FTIA when received
from the court. Alternatively, if the adoption of ADOPTIVE CHILD NAME is completed in India as a Hindu
adoption, we/I agree to send FTIA a copy of all the Indian court documents as soon as we/I return home.

We/I agree not to hold FTIA legally liable and not to pursue any legal action against FTIA in the event
there is a medical/social/developmental/emotional condition present which is not indicated on the medical
information provided, whether detected, observed, and/or diagnosed in India or after return to the United
States. We/I affirm that we/I have had the opportunity to ask any questions or request additional
information prior to travel to India and have also been encouraged to consult with an international
adoption medical specialist before accepting the referral of ADOPTIVE CHILD NAME.

We/I also agree to obtain ADOPTIVE CHILD NAME‘s Certificate of Citizenship within one year of
completing the adoption and to send FTIA a copy of the Certificate of Citizenship when received from the

We/I understand and agree to incorporate this Acknowledgement and Agreement with all the terms of the
Adoption Services Agreement and Statement of Understanding signed earlier in this adoption process.

__________________________________________                        _____________________________
ADOPTING PARENT                                                   Date

__________________________________________                        _____________________________
ADOPTING PARENT                                                   Date

India Acknowledgement & Agreement

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